March 26, 2015 – Despite ambitious efforts to implement Electronic Health Record (EHR) systems, the level of health information exchanged across organizations and care settings in Canada is lagging, according to a new report from the C.D. Howe Institute. In “Missed Connections: The Adoption of Information Technology in Canadian Healthcare,” author Denis Protti argues that there will not be any large-scale benefits from gathering masses of health data until the information is shared among providers and institutions, such as between a family physician and a hospital.
“Survey findings revealed that in primary care only 12 percent of physicians are notified electronically of patients’ interactions with hospitals or send and receive electronic referrals for specialist appointments,” states Protti. He adds that “fewer than three in ten primary care physicians have electronic access to clinical data about a patient who has been seen by a different health organization.”
This limited exchange of e-health records in Canada has negatively impacted the ability of primary care physicians to carry out higher order functions such as e-prescribing, receiving discharge summaries, receiving reports from specialists, receiving lab results electronically, preventative care follow-up, generating a medications list, providing clinical summaries and sending reminder notices. Analyses of EHR programs worldwide show they can improve the quality of care and reduce patient risk, for example, by cutting prescribing errors and by providing and sharing information promptly, which are vital for people with complex conditions whose care is often provided by several different clinicians and organizations.
Highlighted in the report are five principles that should form the basis of a Canadian EHR system:
- Shared electronic records should be regarded as essential to care;
- Features of electronic records systems that get in the way of effective clinical practice should be regarded as safety issues that need to be resolved as a priority;
- Clinicians should have a single point of access to electronic records about patients they are treating, regardless of where the record was created;
- Patients and their caregivers should not find relevant data inaccessible, expensive to access or at risk of loss because of commercial or financial decisions made by EHR system vendors; and
- Patients should ultimately be able to access their EHRs online.
“One key characteristic shared by many leading healthcare jurisdictions is the incentive to improve outcomes for patients at risk, in contrast to the fee-for-service reimbursement models that create incentives for higher treatment volumes,” says Protti. “Leaders need to set goals and incentives for improved quality of outcomes and hold institutions and clinicians accountable for achieving those goals,” he concludes.
The C.D. Howe Institute is an independent not-for-profit research institute whose mission is to raise living standards by fostering economically sound public policies. It is Canada’s trusted source of essential policy intelligence, distinguished by research that is nonpartisan, evidence-based and subject to definitive expert review. It is considered by many to be Canada’s most influential think tank.
Click here for the full report.
For more information contact: Denis Protti, Emeritus Professor, School of Health Information Science, University of Victoria, or Colin Busby, Senior Policy Analyst at the C.D. Howe Institute, at 416-865-1904; E-mail:amcbrien@cdhowe.org.